<%@page pageEncoding="UTF-8"%>
<tiles:insert template="../common/layout.jsp" flush="true">
    <tiles:put name="title">
        <bean:message key="index.title" />
    </tiles:put>
    <tiles:put name="content" type="string">
        <div id="content" class="span10">
            <!-- start: Content -->
            <div>
                <hr>
                <ul class="breadcrumb">
                    <li><a href="#">Home</a> <span class="divider">/</span>
                    </li>
                    <li><a href="#">Forms</a></li>
                </ul>
                <hr>
            </div>

            <div class="row-fluid sortable">
                <div class="box span12">
                    <div class="box-header" data-original-title>
                        <h2>
                            <i class="icon-edit"></i><span class="break"></span>Absence
                            Request
                        </h2>
                        <div class="box-icon">
                            <a href="#" class="btn-setting"><i
                                class="icon-wrench"></i></a> <a href="#"
                                class="btn-minimize"><i
                                class="icon-chevron-up"></i></a> <a href="#"
                                class="btn-close"><i
                                class="icon-remove"></i></a>
                        </div>
                    </div>
                    <div class="box-content">
                        <form class="form-horizontal">
                            <fieldset>
                                <table
                                    class="table table-striped table-bordered table-hover">
                                    <tr class="info">
                                        <td></td>
                                        <td>Staff code : EVR 11</td>
                                        <td>Department : Programmer</td>
                                        <td>Applicant Name: Le Duc
                                            Cuong</td>
                                    </tr>
                                    <tr class="info">
                                        <td><label class="radio">
                                                <input type="radio"
                                                name="optionsRadios"
                                                id="optionsRadios1"
                                                value="Come late"
                                                checked=""> Come
                                                late
                                        </label></td>
                                        <td><label class="radio">
                                                <input type="radio"
                                                name="optionsRadios"
                                                id="optionsRadios2"
                                                value="Leave early">
                                                Leave early
                                        </label></td>
                                        <td><label class="radio">
                                                <input type="radio"
                                                name="optionsRadios"
                                                id="optionsRadios3"
                                                value="Private go out">
                                                Private go out
                                        </label></td>
                                        <td><label class="radio">
                                                <input type="radio"
                                                name="optionsRadios"
                                                id="optionsRadios4"
                                                value="Absence">
                                                Absence
                                        </label></td>
                                    </tr>
                                    <tr class="info">
                                        <td>Period</td>
                                        <td colspan="3">
                                            <div class="control-group">
                                                <label
                                                    class="control-label"
                                                    for="date01">From
                                                    Date</label>
                                                <div class="controls">
                                                    <input type="text"
                                                        class="input-xlarge datepicker"
                                                        id="date01"
                                                        value="02/16/12">
                                                </div>
                                            </div>
                                        </td>
                                    </tr>
                                    <tr class="info">
                                        <td></td>
                                        <td colspan="3">
                                            <div class="control-group">
                                                <label
                                                    class="control-label"
                                                    for="date02">To
                                                    Date</label>
                                                <div class="controls">
                                                    <input type="text"
                                                        class="input-xlarge datepicker"
                                                        id="date02"
                                                        value="02/16/12">
                                                </div>
                                            </div>
                                        </td>
                                    </tr>
                                    <tr class="info">
                                        <td>Time From</td>
                                        <td><div
                                                class="control-group">
                                                <label
                                                    class="control-label"
                                                    for="selectError3">Hour</label>
                                                <div class="controls">
                                                    <select
                                                        id="selectError3"
                                                        style="width: 80px" data-rel="chosen">
                                                        <option>Option
                                                            1</option>
                                                        <option>Option
                                                            2</option>
                                                        <option>Option
                                                            3</option>
                                                        <option>Option
                                                            4</option>
                                                        <option>Option
                                                            5</option>
                                                    </select>
                                                </div>
                                            </div></td>
                                        <td colspan="2">
                                            <div class="control-group">
                                                <label
                                                    class="control-label"
                                                    for="selectError4">Minitues</label>
                                                <div class="controls">
                                                    <select
                                                        id="selectError4"
                                                        style="width: 80px" data-rel="chosen">
                                                        <option>Option
                                                            1</option>
                                                        <option>Option
                                                            2</option>
                                                        <option>Option
                                                            3</option>
                                                        <option>Option
                                                            4</option>
                                                        <option>Option
                                                            5</option>
                                                    </select>
                                                </div>
                                            </div>
                                        </td>
                                    </tr>
                                    <tr class="info">
                                        <td>Time To</td>
                                        <td><div
                                                class="control-group">
                                                <label
                                                    class="control-label"
                                                    for="selectError">Hour</label>
                                                <div class="controls">
                                                    <select
                                                        id="selectError"
                                                        style="width: 80px" data-rel="chosen">
                                                        <option>Option
                                                            1</option>
                                                        <option>Option
                                                            2</option>
                                                        <option>Option
                                                            3</option>
                                                        <option>Option
                                                            4</option>
                                                        <option>Option
                                                            5</option>
                                                    </select>
                                                </div>
                                            </div></td>
                                        <td colspan="2">
                                            <div class="control-group">
                                                <label
                                                    class="control-label"
                                                    for="selectError2">Minitues</label>
                                                <div class="controls">
                                                    <select
                                                        id="selectError2"
                                                        style="width: 80px" data-rel="chosen">
                                                        <option>Option
                                                            1</option>
                                                        <option>Option
                                                            2</option>
                                                        <option>Option
                                                            3</option>
                                                        <option>Option
                                                            4</option>
                                                        <option>Option
                                                            5</option>
                                                    </select>
                                                </div>

                                            </div>
                                        </td>
                                    </tr>
                                    <tr class="info">
                                        <td>Reason</td>
                                        <td colspan="3">
                                            <div
                                                class="control-group hidden-phone">
                                                <div class="controls">
                                                    <textarea
                                                        class="cleditor"
                                                        id="textarea2"
                                                        rows="3"></textarea>
                                                </div>
                                            </div>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td colspan="4"><div
                                                class="form-actions">
                                                <button type="submit"
                                                    class="btn btn-primary">Save
                                                    changes</button>
                                                <button type="reset"
                                                    class="btn">Cancel</button>
                                            </div></td>
                                    </tr>
                                </table>
                            </fieldset>
                        </form>
                    </div>
                </div>
                <!--/row-->
                <!-- end: Content -->
            </div>
            <!--/#content.span10-->
        </div>
        <!--/fluid-row-->

        <div class="modal hide fade" id="myModal">
            <div class="modal-header">
                <button type="button" class="close" data-dismiss="modal">×</button>
                <h3>Settings</h3>
            </div>
            <div class="modal-body">
                <p>Here settings can be configured...</p>
            </div>
            <div class="modal-footer">
                <a href="#" class="btn" data-dismiss="modal">Close</a> <a
                    href="#" class="btn btn-primary">Save changes</a>
            </div>
        </div>
        <div class="clearfix"></div>
    </tiles:put>
</tiles:insert>